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Individual
MRS. ELISABETH BEALE RADISH
Active
Individual
MRS. ELISABETH BEALE RADISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP PC
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
17106
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17106
NURSE PRACTITIONER
TN
01
—
184290
REGISTERED NURSE
TN
01
—
20122365
BORD CERTIFIED
TN
Enumeration date
11/08/2012
Last updated
08/16/2022
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